Psychological interventions in Chronic Illness
10 important questions on Psychological interventions in Chronic Illness
Health psychology interventions for long-term conditions
Health psychologists aim to understand what is mediating the change when successful interventions work and to examine whether evidence for the effect of mediating variables is consistent with theoretical predictions. Additionaly, health psychologists are interested in the factors moderating the effect of an intervention, whether individual, interpersonal or environmental.
Roles for health psychologists
- Pre-intervention research
- provide advice/training to HCPs
- Guideline committees
Type of health psychology interventions
2. treatment of 'psycho-physiological disorders' (chronic fatigue syndrome, chronic pain,...) with the goal to alleviate symptoms and improving functioning
3. addressing psychosocial adjustment to illness (e.g. life after heart attack, living with anxiety/depresion following a heart attack, ...)
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Interventions to help patients to manage their illness
- interventions targeting motivation and the control of behaviour
- developing interventions for the management of long-term conditions
Educational or information-based interventions
Targeting illness-related behaviours by addressing motivation/control of action
- motivation
- control of action
Motivational interventions want to change beliefs and attitudes that shape illness-related behaviours. They help patients consider different courses of action and determine priorities.
A range of behavioural techniques are:
- teach problem solving
- develop 'if-then' plans
- behavioural experimentation with feedback to increase self-efficacy
- collaborative development of 'implementation intentions'
Interventions to treat (psycho-physiological) symptoms
- not driven by an overarching theoretical model, but by a model of the condition or symptoms to be managed
- often inspired by CBT type of interventions; try to relate cognitive factors to emotional responses to behavioural attempts to manage the situation
- the example of 'chronic fatigue syndrome' CFS
Interventions to Address Psychological Adjustment to Illness
* adaptation to limitations
* achieving acceptable quality of life in various domains (work, social, leisure, ...)
* maintaining satisfying relationships
* manage negative emotions or psychological disorders
- Again... popular is the use of CBT and coping skills training to reduce and manage stress, and interventions to regulate emotions.
Interventions to adress psychological adjustment to illness
* relaxation
* meditation
* mindfulness training
- often in combination with cognitive techniques (cognitive behavioural stress management; CBSM)
* cognitive reframing
* enhancing social support by interpersonal skills training
* enabling greater sense of control
* redirect coping resources to aspects that are controllable and amenable to change
The use of new technology - internet, telephone and mobile phone interventions
- use for preventive and health promotion purposes
- but also to manage patiens' chronic conditions
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